Understanding Addison's Disease -- Diagnosis & Treatment

How Is Addison's Disease Diagnosed?

Addison’s disease can present as an acute illness or come on gradually. With chronic Addison’s, the symptoms are vague and non-specific, and Addison's disease can be difficult to diagnose. Often, it's first detected through routine blood tests in a hospital or doctor's office to check for sodium, potassium and white blood cell levels. The doctor will also check for hyperpigmentation, or darkening, of the skin or gums -- a sign of long-term Addison's.

The most definitive way to diagnose the condition is to measure hormone levels in the blood and urine before and after giving ACTH. ACTH is a hormone in the brain that, when activated, normally increases the amount of cortisol being produced by the adrenal glands. Measuring ACTH levels can help distinguish whether Addison's disease is a caused by a problem in the adrenal gland or the brain.

X-rays, CT scans, and a tuberculosis skin test may also be used to help pinpoint the cause.

What Are the Treatments for Addison's Disease?

Since Addison's disease is caused by a lack of normal hormones produced by the adrenal glands, it can be treated by replacing those hormones. This can be done with once- or twice-daily tablets of hydrocortisone, a steroid hormone. If needed, aldosterone can be replaced with a synthetic steroid, fludrocortisone acetate (brand name Florinef), which is taken orally once a day. These medications need to be increased during times of stress, infection, surgery, or injury.

Treatment is almost always completely successful. When treated, people with Addison's disease can lead a full and normal life. It is, however, important to carry a medic alert bracelet and emergency ID card at all times and to keep a small supply of medications at work or school. Even missing one dose can be dangerous.

In patients suspected of having an Addisonian crisis, doctor-prescribed injections of salt, fluids, and glucocorticoid hormones may be given immediately -- even before a diagnosis of Addison's disease is confirmed.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on March 01, 2015

Sources

SOURCES: 

The Mayo Clinic. 

National Institute of Diabetes & Digestive & Kidney Diseases. 

National Adrenal Diseases Foundation. 

Jeremy Sussman, PhD, University of California Berkeley.

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